Doctor's Responsibility

Children born into an alcoholic family
are likely to inherit the disease of addiction, and therefore should be as
careful about any alcohol or drug use as a diabetic is careful about sugar
intake.

Family Physicians are often the
first stop in drug and alcohol prevention. For many, drug addiction can
actually start during a regular yearly doctor's visit, with a prescription to
pain killers. It is the physician's job to ask questions about how the patient
is feeling and if there are any physical issues such as pain. Questions about
family addiction are essential before prescribing pain killers.

In the past, before the advent of what
we are calling pain-killers, physicians might tell a patient in pain, "take two
aspirin and call me if there is still a problem". Now we have developed an arsenal of strong,
addictive but highly effective pain-killers. These include such drugs as
oxycontin, percocet, xanax, etc. Now if
the pain is more than a mild headache, a physician can prescribe, based on a
patient's reported symptoms, the more effective but addictive pain-killers.

Unfortunately, many patients have a
family history of addiction (i.e. alcohol or drugs). With this genetic predisposition, prolonged addiction
to the pain killers can become a lethal side effect. Even a patient as young as fourteen years old
with a genetic predisposition is more likely to become addicted to alcohol,
drugs or prescribed pain-killers.

There is no hard data that will predict
addiction to pain-killers or that would predict those who will become addicted
to pain-killers. However we now know that
it is far more likely that patients given pain-killers even for legitimate will
reasons, are likely to become addicted if they have addiction in their family.

I am in strong support of NIAAA's
position for all physicians to counsel their young patients not only about the
dangers of excessive alcohol use but about the genetic predisposition for
addiction. (See article below.) Children born into an alcoholic family are
likely to inherit the disease of addiction, and therefore should be as careful
about any alcohol or drug use as a diabetic is careful about sugar intake.

Physicians
often fail to counsel their young adult patients about excessive alcohol use

From a study led by
the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National
Institutes of Health.

NIAAA guidelines for low risk drinking call for men to drink no more
than four drinks in a day and no more than 14 drinks per week. For women, the guidelines are three or fewer
drinks per day and no more than seven drinks per week. Previous studies have shown that screening
and brief interventions by health care providers – asking patients about
alcohol use and advising them to reduce risky drinking -- can promote
significant, lasting reductions in drinking levels and alcohol-related
problems. In addition to NIAAA, professional groups such as the American
Medical Association and the American Society of Addiction Medicine, as well as
the U.S Preventive Services Task Force, recommend routine screening for alcohol
misuse in primary care and brief interventions for individuals who screen
positive.

In the current study, Ralph W. Hingson, Sc.D., director of NIAAA's
division of epidemiology and prevention research, and colleagues at Boston
University School of Public Health and BostonMedicalCenter
conducted a random survey of more than 4,000 people in the United States between the ages of
18 and 39. The researchers asked survey participants about their drinking
habits and whether they had been seen by a doctor during the past year. Those
who had seen a doctor were asked additional questions to determine whether the
doctor had assessed their alcohol use and advised them about safe drinking
practices during the visit. The researchers report that
16 percent of those surveyed were non-drinkers, 24 percent drank at or below
daily or weekly limits, 47 percent exceeded daily or weekly limits, and 13
percent exceeded both. The
findings are online in the Journal of General Internal Medicine.

"Two-thirds of the people we surveyed had been seen by a doctor in the
past year," says Dr. Hingson. "However, of individuals
whose drinking exceeded NIAAA guidelines, only 49 percent recalled being asked
about their drinking, and only 14 percent were counseled about it. Young adults between ages 18 and 25 were the
most likely to report drinking in excess of NIAAA guidelines, and only 34
percent of them were asked about drinking by their doctors, compared with 54
percent of adults ages 26 to 39."

"In the United States,
excessive alcohol use is the third leading preventable cause of death," says
NIAAA Acting Director Kenneth Warren, Ph.D. "It's also a
significant cause of disability for men and women in this country. The findings reported by Dr. Hingson and his
colleagues indicate that we must redouble our efforts to help clinicians make
alcohol screening and brief intervention a routine part of patient care in the
United States."

Dr. Warren adds that NIAAA's 'Helping Patients Who Drink Too Much: A
Clinician's Guide, available at the NIAAA website, provides a research-based,
simplified approach to alcohol screening and brief intervention for both
primary care and mental health clinicians.

The National Institute on Alcohol Abuse and Alcoholism, part of the National
Institutes of Health, is the primary U.S. agency for conducting and
supporting research on the causes, consequences, prevention, and treatment of
alcohol abuse, alcoholism, and alcohol problems. NIAAA also disseminates
research findings to general, professional, and academic audiences. Additional
alcohol research information and publications are available at www.niaaa.nih.gov.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27
Institutes and Centers and is a component of the U.S. Department of Health and
Human Services. NIH is the primary federal agency conducting and
supporting basic, clinical, and translational medical research, and is
investigating the causes, treatments, and cures for both common and rare
diseases. For more information about NIH and its programs, visit www.nih.gov.

Reference:

Young Adults at Risk for Excess Alcohol Consumption Are Often Not Asked
or Counseled About Drinking Alcohol
Ralph W. Hingson, et al.
Journal of General Internal Medicine
(September 21, 2011)

NIAAA Research Focuses
on Two Problem- Drinking Issues

The National Institute on
Alcohol Abuse and Alcoholism (NIAAA) recently concluded two studies relating to
problem drinking. One study demonstrates that physicians frequently neglect to
screen often fail to screen young adult patients for excessive alcohol use.
Another study illustrates that social media postings of references to
various aspects of dangerous problem drinking are likely signs of clinically
significant alcohol problems among those students.